Family Law Loan Application Apr 2025

Partner Details

Client Details

Case information:

Financial Information

Assets - Properties

Assets - Bank Accounts, Savings and Investments

Assets - Other Assets

Liabilities

Independent Legal Advice

Document upload

Declarations

Expense Breakdown for Maintenance Loan:

Expense Breakdown for Maintenance Loan:

Family Law Loan - Application Form

Thank you for your interest in applying for the Ampla Finance Family Law Loan.

For more information about the loan, please visit our website here.

To understand how we handle your clients personal data, please review our privacy policy.

Please note that the Family Law Loan is provided by Ampla Consumer Finance Limited.

Important Reminder: As you complete this application, we recommend that you save your progress regularly.

To the best of your knowledge:*

Rows	Response
The borrower has been provided with Ampla's privacy statement and understands that their data will be stored, processed, and may be used for credit and identity checks as part of this application.
You confirm that you have undertaken the required KYC and AML checks on the borrower, in line with the SRA regulations.
The borrower has instructed the application to be commenced on their behalf and has given permission to share relevant information with the agreed third parties, including credit reference agencies and regulatory bodies where required.
I confirm that the borrower has given their explicit consent for Ampla to record and store any special category data that is confirmed during the application process.

Triage

If you have marked any items as false, Please contact Ampla Finance to discuss your application before proceeding on 0800 009 6590 (selecting option 2)

Solicitor Name*

First NameLast Name

Email*

example@example.com

Contact Number

Firm Address*

Please provide the name and email address of any additional contacts at your firm who should be included in communications regarding this application.

Type of loan being applied for

Name*

First NameMiddle NameLast Name

Email*

example@example.com

Contact Number*

Date of Birth*

Nationality*

Residency*

Visa Type*

Details of visa type*

Current Address*

Years at Address*

Years

Months*

Months

Total Address 0*

Total Years

Previous Address 1*

Years at Address 1*

Years

Months*

Months

Total Address 1*

Total Years

Previous Address 2*

Years at Address 2*

Years

Months*

Months

Total Address 2*

Total Years

Previous Address 3*

Years at Address 3*

Years

Months*

Months

Total Address 3*

Total Years

Employment Status*

Occupation*

My client has unspent criminal convictionsMy client does not have any unspent criminal convictions

Please provide further detail regarding any unspent criminal convictions.

YesNo

Mental healthPhysical health

Please provide further details*

YesNo

Based on the information provided, we are unable to proceed with this application.

Power of Attorney Name

First NameLast Name

Power of Attorney Contact Number

Power of Attorney Email

example@example.com

YesNo

Please detail any other practical needs to help complete the application*

EmailPhoneLetter

YesNo

Please list age of dependents*

Rows	Age
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5
Dependent 6

Date of cohabitation (if applicable)

Date of marriage*

Date of separation*

Current stage of financial proceedings*

YesNo

Please confirm the status and likely outcome of the proceedings*

Total facility amount requested*

Rows	Amount (£)
Total unpaid costs outstanding, to be repaid by the loan (if applicable)
Cost estimate to Disclosure
Cost estimate to FDR (if applicable)
Cost estimate to final hearing:
Post settlement / enforcement costs
Cost estimate for associated proceedings e.g. children matters, non molestation order etc (if applicable)

Total facility amount requested*

Rows	Amount (£)
Total unpaid costs outstanding, to be repaid by the loan (if applicable)
Cost estimate to FDR (if applicable)
Cost estimate to final hearing:
Post settlement / enforcement costs
Cost estimate for associated proceedings e.g. children matters, non molestation order etc (if applicable)

Total facility amount requested*

Rows	Amount (£)
Total unpaid costs outstanding, to be repaid by the loan (if applicable)
Cost estimate to final hearing:
Post settlement / enforcement costs
Cost estimate for associated proceedings e.g. children matters, non molestation order etc (if applicable)

Total facility amount requested*

Rows	Amount (£)
Total unpaid costs outstanding, to be repaid by the loan (if applicable)
Post settlement / enforcement costs
Cost estimate for associated proceedings e.g. children matters, non molestation order etc (if applicable)

Total facility requested*

YesNo

Primary case reference*

Risk of parties reconciling*

Please provide further information as to why the parties may reconcile*

What is the headline strategy for the case*

YesNo

You will be asked to upload this document at the end of the application

Please confirm the impact the agreement is likely to have on the outcome of the case*

YesNo

What are they claiming*

What is the value of their potential claim*

YesNo

You will be asked to upload this document at the end of the application

What was the response to the offer*

What is the most likely outcome / settlement you would expect the Borrower to achieve?*

In your opinion, what is the "worst case scenario" outcome / settlement that has potential to materialize for the Borrower?*

Estimated time for final settlement to be received*

Please confirm the Borrowers housing arrangements once the financial proceedings are concluded*

Type of property*

No of bedrooms*

Location of property*

Expected value of property purchase*

Borrowers mortgage capacity*

YesNo

You will be asked to upload this document at the end of the application

Income per month*

Rows	Amount (£)
Employed income
Self-employed income (including salary and dividends)
Child / Spousal maintenance
Pension
Investment
Benefits

Total income per month (AUTO SUM)*

Essential expenditure per month*

Rows	Amount (£)
Rent / mortgage
Unsecured credit payments (loans, credit cards, mail order etc)
Council Tax
Uility Bills ( gas / electricity / water)
Buildings / contents insurance
Travel (train / bus / car insurance / tax / maintenance / fuel)
Food and Drink
Essential clothing and shoes (everyday clothes, workwear, school uniform etc).
TV / Internet / Phone packages
Pet costs (e.g. food, insurance, care)
Childcare costs
Adult care costs
Basic Entertainment / holidays
Savings

Total expenditure per month (AUTO SUM)*

YesNo

Please provide details of their occupation*

Please list any expenses the borrower wishes to include as part of their maintenance loan request.

For each item, indicate the amount, how often the expense occurs (e.g. monthly, quarterly, one-off), and the length of time it needs to be covered.

Rows	Item Type	Amount (£)	Frequency	Period of Cover
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
Item 7
Item 8

Please provide their estimated earnings*

UK Properties:*

Rows	Property Type	Owner	Post Code	Flat/House No	Street Name	Type of Property	Property Style	No of Bedrooms	No of Reception Rooms	Construction Type	Year Built	Has Parking / Garage	Ex Local Authority	Value Source	Property Value (£)	Mortgage Balance inc early redemption penalty (£)	Capital Gains Tax (£)	Estate Agents & Solicitor Fees (£)
Property 1
Property 2
Property 3
Property 4
Property 5

YesNo

UK Properties (Additional):*

Rows	Property Type	Owner	Post Code	Flat/House No	Street Name	Type of Property	Property Style	No of Bedrooms	No of Reception Rooms	Construction Type	Year Built	Has Parking / Garage	Ex Local Authority	Value Source	Property Value (£)	Mortgage Balance inc early redemption penalty (£)	Capital Gains Tax (£)	Estate Agents & Solicitor Fees (£)
Property 6
Property 7
Property 8
Property 9
Property 10

Bank Accounts, Savings and Investments:

Rows	Item	Owner	Security/Company name	Location	Value source	Asset value (£)	Debt (£)	Cost of sale (£)
Item 1
Item 2
Item 3
Item 4
Item 5

YesNo

Bank Accounts, Savings and Investments (Additional):

Rows	Item	Owner	Security/Company name	Location	Value source	Asset value (£)	Debt (£)	Cost of sale (£)
Item 6
Item 7
Item 8
Item 9
Item 10

Other Assets:

Rows	Item	Owner	Asset information	Location	Value source	Asset value (£)	Debt (£)	Cost of sale (£)
Item 1
Item 2
Item 3
Item 4
Item 5

YesNo

Other Assets (Additional):

Rows	Item	Owner	Asset information	Location	Value source	Asset value (£)	Debt (£)	Cost of sale (£)
Item 6
Item 7
Item 8
Item 9
Item 10

Please confirm which assets the Borrower intends to use to repay the Ampla loan*

Are there any risks to using this as a repayment vehicle (e.g spouse dissipating assets, likelihood of mesher order etc).*

Liabilities:

YesNo

Liabilities (Additional):

If the loan is approved, the customer must get independent legal advice before signing the loan agreement. We can connect them with ila.co.uk, who offer this service for £300. Or, the customer can choose their own solicitor. Please confirm which option the customer prefers.*

Add ILA fee to loanPay ILA fee upfront

We kindly request you upload all the documents that correspond to the information provided during the application process. These documents are essential for us to conduct a comprehensive and accurate underwriting assessment.

Power of Attorney Evidence

Pre or post nuptial agreement

Form E (Borrower and Spouse)

ES2

Settlement offers made / received

Evidence of property valuations (RICS Valuation & Estate Agents Estimates)

Evidence of mortgage balances

Evidence of Bank Accounts, Savings and Investments

Mortgage capacity reports*

The Information provided on this application form is correct to the best of my knowledge;I am authorise by the Client to submit this application on their behalf;The client named above has been provided with a copy of the Ampla Finance Privacy Policy;The client named above provides their consent for Ampla Operations Limited to perform third party checks, as detailed in Section 4 of the Ampla Finance Privacy policy; andThe client named above has given their explicit consent for Ampla to record and store any special category data that has been confirmed during the application process.

Signature*

Print Name*

First NameLast Name

Sign Date*

Date

Expense/Creditor details

Value source